鼻内窥镜手术治疗慢性鼻窦炎及鼻息肉679例临床分析

The Treatment Outcome of Endoscopic Sinus Surgery in 679 Cases

目的总结鼻内窥镜手术治疗慢性鼻窦炎及鼻息肉的临床经验。方法对6年来完成的鼻内窥镜手术1341侧(679例)分成初期组和近期组进行鼻内窥镜随访检查。结果初期组总治愈率为68.8%,好转率为28.9%,无效为2.3%;近期组总治愈率为87.6%,好转率为12.4%,无效0%(P<0.01)。结论熟悉额窦、蝶窦和钩突解剖特点、完整切除钩突、做好中鼻甲成形术有助于提高手术疗效。采用气管插管全身麻醉及控制性低血压技术能有效地减少术中创面出血。

Purpose To evaluate the experience in the treatment of chronic sinusitis and nasal polyp by nasal endoscopic surgery. Methods 679 patients (1341 sides) received endoscopic sinus surgery in six years. All patients were divided into the primary stage group and the recent stage group. The patients were followed up by endoscopy in six moths after operation. Results The curative rates of the primary stage group and the recent stage group were 68.8% and 87.6% , The improving rates in the two groups were 28.9% and 12.4% ( P < 0.01) .Conclusion It is helpful to improve the outcome in endoscopic sinus surgery if the operator is familiar with the anatomic characteristic signs of frontal sinus, sphenoid sinus and uncinate process. Removing the uncinate process totally and reshaping the middle turbinate is a very important technique to improve the operative results. The controlled lower blood pressure technique can decrease bleeding in the operative field effectively.